Pet evaluation and triage system

ABSTRACT

A system is provided to provide triage recommendations for animals. The system accesses a syndrome mapping of syndromes to complaints, each syndrome having a triage category. The system accesses a complaint mapping of complaints to symptoms. Each symptom for a complaint has a weight. The system receives indications of a current complaint and current symptoms of an animal. Each current symptom has a score. The system identifies the triage category based on a syndrome to which the current complaint and the current symptoms apply, factoring in the weights and the scores. The system provides a recommendation for the animal based on the identified triage category.

CROSS-REFERENCE TO RELATED APPLICATION(S)

This application claims priority to U.S. Provisional Application No.62/840,260 filed on Apr. 29, 2019, and it is a continuation of U.S.Non-Provisional application Ser. No. 16/749,231 filed on Jan. 22, 2020,which is hereby incorporated by reference in its entirety.

BACKGROUND

Millions of people own pets. Some pets may need medical attentionfrequently, and almost all pets need medical attention at some time. Toservice the medical needs of pets, veterinarians run clinics so that thepet owners can bring their pets to receive medical attention. Most petowners, however, cannot effectively triage a current condition of a petto know whether they should seek emergency attention for their pet, calla veterinarian to discuss the pet's condition, wait and see how thecondition progresses, and so on. Moreover, the urgency of seekingmedical attention for a condition may vary based on the species, breed,age, and so on of the pet. This variation makes it very difficult forthe vast majority of pet owners to effectively triage a currentcondition. As a result, many pets are taken to a clinic even when notwarranted by the condition. Conversely, many pets are not taken to aclinic even when warranted by the condition sometimes with direconsequences.

Because so many pet owners take their pets to a clinic when notwarranted by the pet's condition, the overall cost of pet ownershipincreases. In addition, more clinics and larger clinics are needed toprocess pets with such conditions. Moreover, a clinic may spend so muchtime triaging pets with such conditions that the treatment of pets withmore serious conditions may be delayed.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a complaint display page that allows an owner to identify acomplaint.

FIG. 2 is a symptom display page that allows entry of symptomsassociated with a complaint.

FIG. 3 illustrates a symptom analysis display page.

FIG. 4 illustrates a specify complaint display page.

FIG. 5 illustrates a specify symptoms display page.

FIG. 6 illustrates specification of a 1-10 scale point option.

FIG. 7 illustrates a specify syndrome display page.

FIG. 8 is a block diagram that illustrates components of the PET systemin some embodiments.

FIG. 9 is a flow diagram that illustrates the processing of an analyzecomponent of the PET system in some embodiments.

FIG. 10 is a flow diagram that illustrates the processing of an identifycomplaints component of the PET system in some embodiments.

FIG. 11 is a flow diagram that illustrates the processing of a generaterecommendation component of the PET system in some embodiments.

FIG. 12 is a flow diagram that illustrates the processing of an identifysyndrome component of the PET system in some embodiments.

FIG. 13 is a flow diagram that illustrates the processing of a generatecategorization component of the PET system in some embodiments.

FIG. 14 is a flow diagram that illustrates the processing of a checkconsultation availability component of the PET system in someembodiments.

FIG. 15 is a flow diagram that illustrates the processing of a conductelectronic check component of the PET system in some embodiments.

FIG. 16 is a flow diagram that illustrates the processing of a definecomplaints component of the PET system in some embodiments.

DETAILED DESCRIPTION

Methods and systems are provided for generating recommendations based ona triage for an animal. In some embodiments, a pet evaluation and triage(“PET”) system is a computer-based system that can be used by animalclinics, veterinarians, and other care providers to allow owners ofanimals (e.g., dogs, cats, and horses), an animal shelter, or otherentities responsible for animals to perform a triage on an animal byelectronically providing information describing the condition of theanimal and receiving recommendations on how to proceed. For example, ifthe described condition indicates that the condition may be veryserious, the recommendation may indicate that the animal may needemergency treatment and have the animal evaluated by a care providerimmediately. By providing effective and timely triaging of an animal,the PET system allows a responsible entity to receive an indication ofthe severity of the condition (e.g., emergency or worrisome) and receivea recommendation on how to proceed. In this way, a responsible entitycan seek appropriate attention medical that may avoid the expense andwasted resources (e.g., taking an animal to a care provider) ofunnecessary interventions by a care provider.

The PET system also allows care providers to access information relatingto the triaging of animals under their care and communicateelectronically with the responsible entities to provide advice on carefor animals. If the described condition is not very serious but may needattention, the PET system allows a care provider to review theinformation describing the condition of the animal and to initiate anelectronic consultation (e.g., a chat session) to obtain any additionalinformation that is needed and to provide a recommendation to theresponsible entity. The recommendation may be to take the animal to aclinic immediately or the next day, call if the condition worsens, andso on. Both the initial triaging by the responsible entity and theelectronic consultation contribute to more effective outcomes byidentifying the urgency of the pet's condition and proceeding based onthat urgency. Because of the technology that supports triaging andelectronic consultations, the effectiveness of health care increaseswhile the costs decrease. In the following, the PET system is describedprimarily in the context of an animal that is a pet, a care providerthat is a clinic, and a responsible entity that is a pet owner, althoughthe PET system can be used for any type of animal, care provider, orresponsible entity.

In some embodiments, the PET system receives from a pet ownerinformation relating to a pet, a complaint indicating condition of thepet, and ratings of symptoms associated with the complaint. For example,the information relating to the pet may be a signalment that identifiesspecies, breed, sex, age, and so on. A complaint may be that “a foxtailis lodged in the fur of the dog.” The symptoms queried may include signsof pus, signs of irritation, abnormal breathing, high temperature,bleeding, and so on. A rating may be based on a scale of 1 to 10, aBoolean value, and so on. For example, a rating of 2 for the symptom ofbleeding may indicate that the bleeding appears to be not too serious,while a rating of 10 may indicate that the bleeding is very serious.

After receiving information about the complaint and symptoms, the PETsystem identifies a triage category for the pet based on weightsassociated with symptoms associated with the complaint. For example,bleeding may have a higher weight than inflammation because it is likelymore urgent to take action when the pet is bleeding than when the pethas inflammation. The triage categories may include emergency, urgent,seek medical advice, non-threatening, and so on. The PET system thenprovides a recommendation based on the triage category. For example,when the triage category is emergency, the recommendation may be to takethe pet to a clinic immediately.

In some embodiments, the PET system may allow an electronic consultationdepending on the urgency of the triage category. Each complaint may havean associated base response time indicating by what time the clinic willrespond to a request for an electronic consultation. If the baseresponse time is within the consultation hours (e.g., 6:00 a.m. to 9:00p.m. daily) during which an electronic consultation is available, thePET system sets the response time to the current time plus the baseresponse time. If, however, a portion of the base response time is notwithin the consultation hours, the PET system sets the response time sothat entire base response time is within the consultation hours. Forexample, if the base response time is four hours, it is 6:00 p.m., andthe consultation hours are 6:00 a.m. to 9:00 p.m. daily, the PET systemsets the response time to 7:00 a.m. on the next day. Given theworse-case response time, if the pet owner decides to proceed with anelectronic consultation, the PET system notifies the clinic of therequested electronic consultation.

FIG. 1 is a complaint display page that allows a pet owner to identify acomplaint. The complaint display page 100 includes a search term area110 and complaint areas 120 and 130. The search term area indicates thesearch terms that the pet owner specified, namely, “ate lilies.” Eachcomplaint area provides information relating to a candidate complaintthat matches the search terms. Each complaint area initially contains a“choose” button and a “see synonyms” link. When an owner selects thechoose button, the PET system selects the complaint as the indication ofthe potential problem with the pet and displays a “remove” button tode-select the complaint. When an owner selects the see synonyms link,the PET system displays synonyms relating to the complaint and a hidesynonyms link. The owner may select the “try a different search” link toconduct a new search for complaints. When the owner selects the“continue” button, the PET system proceeds to prompt the owner for thesymptoms associated with the complaint.

FIG. 2 is a symptom display page that allows entry of symptomsassociated with a complaint. The display page 200 includes a complaintarea 210, a vitals area 220, and a symptoms area 230. The complaint areaconfirms the complaint that the pet owner selected on the complaintdisplay page. The vitals area relates to entry of vital information,such as temperature. The symptoms area displays symptoms associated withthe complaint, such as discomfort level and energy level. Each symptomhas a level bar 231 to allow the pet owner to specify the level of thesymptom in a range such as no discomfort to extreme discomfort.Drop-down list 232 allows the owner to choose a time period to indicatewhen the complaint arose. The symptom relating to vomiting includes yesand no buttons 233.

FIG. 3 illustrates a symptom analysis display page. The symptom analysisdisplay page 300 displays results of the triage analysis based on thecomplaint and symptoms identified by the pet owner. Area 301 confirmsthe identity and key information about the patient. Area 302 confirmsthe identity of the clinic that the pet owner's account is affiliatedwith. Title area 303 confirms the complaint that the pet ownerspecified. Recommendation block 304 includes a recommendation title 305that lists the urgency such as “Emergency,” “Urgent,” “Seek medicaladvice,” “Worrisome,” and “Non-threatening.” The recommendation blockalso summarizes how long the pet owner has to take action. “Take action”tab 306 provides a recommendation 307 (e.g., contact clinic right away),a button 308 to call the clinic, and a button 309 to request anelectronic consultation. If the clinic is closed, the take action tabprovides information on how to take the action (e.g., wait until clinicopens or go to an after-hours clinic). Emergency Block 320 illustrates a“Contact Poison Control” tab with poison control information that isdisplayed as appropriate when the complaint is configured to provide theinformation. Worrisome block 330 illustrates a “Get Insight” tab that isdisplayed with relevant articles and references as may be configured foreach complaint.

The provider of the PET system may allow a clinic to fully specifyparameters relating to identification of a triage category so that eachclinic can tailor the PET system based on its own expert medicalopinions. The parameters include syndromes, complaints, symptoms,weights, and so on. Alternatively, the provider of the PET system maymaintain full control over the parameters and not allow a clinic tochange the parameters. FIG. 4 illustrates a specify complaint displaypage. The specify complaint display page 400 allows a complaint and itssymptoms to be specified. The display page includes a complaint detailsarea 410 containing a name field and a minimum category field. Theminimum category field indicates that if this complaint is specified,the triage category will not be below the minimum category. Thecheckboxes indicate whether the complaint is currently active, the sexof the animal to which the complaint applies, whether the complaintindicates a poisoning, and whether an electronic consultation is allowedfor the complaint (e.g., only for non-emergencies). The complaintsymptom area includes each symptom that has been specified for thiscomplaint. Each symptom area 420 includes the name of the symptom, itsweight, and whether the symptom is currently active for this complaint.The add symptom button allows a new symptom to be added.

FIG. 5 illustrates a specify symptoms display page. The specify symptomsdisplay page 500 includes a symptom details area 510 and a scale pointsarea 520. The symptom details area includes a display name field and afield type area. The field type area includes a field type field andcheckboxes to indicate whether the scoring is high to low, the displayis high to low, and the symptom is a vital symptom. The field typespecifies the way this symptom is scored. “Boolean” indicates that theanswers equate to numerical values of 0 or 1. “Scale” means that the petowner will see a clickable scale having 10 segments, with the numericalvalues for the triaging in the range of 0 to 9. “Numeric” means theanswer to the question must be in the form of an integer, for example,body temperature. “Select” means that the answers to this question willbe selected from a list of predetermined options with each option havinga predetermined integer value. The high to low checkbox indicates if thenumerical scale value should be inverted before calculation. The displayhigh to low checkbox indicates if the scale displayed to the user shouldbe reversed. The vital checkbox indicates if this symptom is a vital,which means that the symptom will be before other symptoms in thesymptom display page. The scale points area specifies the actualnumerical answer options offered for the symptom. The drop-down listidentifies the scale point options such as Boolean and 1-10. The specifysymptoms display page 500 illustrates specification of a Boolean scalepoint option.

FIG. 6 illustrates specification of a 1-10 scale point option. Thesymptoms may include the following:

Onset

Severity

Frequency

Energy level

Pain level

Change in condition

Breathing difficulty

Coughing

Mucous membrane coloration

Appetite behavior

Drinking behavior

Urination description

Bowel movements description

Vomiting

Swelling

Signs of infection

Bleeding

Improvement

Discomfort

Temperature (optional)

Respiratory rate (optional)

The PET system solicits rating values for the symptoms from the users inone of the following formats:

-   -   Yes/No—For this format, the pet owner is asked a question that        solicits a binary response.    -   Lowest to Highest—For this format, the pet owner is presented        with a scale that has clearly demarcated extremes (e.g., “No        Discomfort” and “Extreme Discomfort”). The pet owner enters a        value on a scale to indicate the relative severity of the        symptom with respect to the extremes.    -   Diverging—For this format, the pet owner can select one of a        discrete set of options. These options are “centered” at Normal        but can diverge from Normal in two directions. As an example,        the PET symptom may ask the pet owner to rate the color of the        pet's mucous membranes. In this case, a neutral response is        “Normal Pink.” However, the pet may also present with “Bright        Red” colored gums or “White” colored gums. These represent two        different clinical signals, both of which are severe but which        diverge from neutral differently.

In order to leverage these symptom responses in the model, each formatis transformed as follows:

-   -   Yes/No format questions are coded as either 1 or 0,        respectively.        -   Yes=1        -   No=0    -   Lowest to Highest questions are coded as an integer from 0 to 9.        -   No Discomfort=0        -   Extreme Discomfort=9    -   Diverging format questions map individual responses to a number.        The number in this case captures severity with respect to        neutral.        -   Excessive Drinking=3        -   More than Normal=2        -   Slightly More than Normal=1        -   Normal=0        -   Slightly Less than Normal=1        -   Less than Normal=2        -   Not at All=3

The PET system employs a statistical model with weights (e.g.,clinic-specific weights) to codify the relative importance of eachsymptom to the chief complaint. These weights may take a value between 1and 10 and are specific to the chief complaint and synonym pair.

At the modeling stage, the PET system may employ the following algorithmto estimate the urgency associated with the chief complaint. Thevariables for the algorithm are

-   -   Y_(i): The absolute value of the input scale value for symptom i    -   n_(i): The absolute maximum value of the input scale value for        symptom i    -   p_(i): The true underlying probability of observing a value of Y        out of n, for symptom i    -   w_(i): The weight associated with symptom i    -   a, a_(i), s, t, μ: Scalar model parameters        The algorithm employs a Bayesian grouped logistic regression        model based on the following assumptions.

Y_(i)|n_(i), p_(i)˜Binomial(n_(i), p_(i))

logit(p _(i))=a+a _(i)

a_(i)˜N(0,s²/w_(i) ²)

a˜N(0,t²)

The hyperparameters s and t are set to reasonable values to ensurenon-informative priors on both a and a_(i). The PET system fits themodel using importance sampling. The PET system draws a vector ofsimulated values of the parameter a from the joint posterior of:

(μ, a_(i), s, t)|Y

The posterior simulations of a|Y are then transformed to the probabilityscale using an inverse-logit transform, μ, which represents the urgencyof the chief complaint. The simulated values of urgency μ serve as thebasis for the following classification stage.

In order to arrive at a recommendation, the urgency simulations areinput into a Bayesian classification framework. The framework outputsone of four categories:

-   -   Non-Threatening    -   Worrisome    -   Urgent    -   Emergency        The category “Seek medical advice” is generated only by the        action of other filters and is not output by the statistical        model.

Each of these categories is mapped to a range of urgency represented asR1, R2, R3, and R4. The PET system generates a recommendation asrepresented by the following equation:

Recommendation=max_(i) Pr(μ ∈ R _(i)|Data)

The PET system may make personalized recommendations based on historicaldata of recommendations (R_(i)) made by responsible entities, clinics,or individual care providers. For example, once sufficient historicaldata is collected for a clinic, the PET system may train a machinelearning algorithm using animal signalment, complaints, etc. as featurevectors labeled with a clinic's urgency assignment. In this way, themodel learns the clinic's preferences for certain levels of urgency.

FIG. 7 illustrates a specify syndrome display page. The display page 700includes a name and minimum category field. The minimum category fieldindicates that if this syndrome applies, the triage category will not bebelow the minimum category. The pet details area specifies thesignalment to which this syndrome applies. The add previous diagnosisbutton is selected to specify a previous diagnosis for this syndrome toapply. The pet species and breeds area specifies the species and breedsto which this syndrome applies. The chief complaints and secondarycomplaints area allow complaints to be added for this syndrome. A chiefcomplaint indicates a primary condition that signaled to the pet ownerthat the pet may be experiencing an adverse clinical event. A seconddegree complaint indicates any ancillary conditions experienced by thepet. The follow-up symptoms area allows questions to be specified to beasked of an owner.

FIG. 8 is a block diagram that illustrates components of the PET systemin some embodiments. The PET system 800 is implemented on a PET systemserver 810 and client devices such as clinic computer systems 840 andowner computer systems (e.g., smartphones) 850 via communicationschannel 830 (e.g., Internet and cellular). The PET system server mayalso be cloud-based and serve multiple unrelated clinics. The PET systemserver includes an analyze component 811, an identify complaintscomponent 812, a generate recommendation component 813, an identifysyndrome component 814, a generate categorization component 815, a checkconsultation availability component 816, a conduct electronic checkcomponent 817, and a define complaints component 818. The PET systemserver also includes a parameter store 819 and an animal store 820. Thefollowing flow diagrams describe the processing of the components. Theclient devices may include client-side applications for interfacing withthe PET system or a web browser for accessing webpages provided by thePET system. The location of the components and the stores may bedistributed so that, for example, a clinic may run the PET systemlocally and the parameter store and the animal store may be storedlocally. The pet owners interact with a client-side app or webpages toidentify complaints and symptoms, specify signalment of their animal,and receive recommendations. The animal store contains information oneach animal, such as name, species, breed, sex, age, previous diagnoses,and so on. The parameter store stores the parameters defined by theprovider of the PET system or a clinic, including symptoms, complaints,and syndromes, as illustrated by the following tables.

Syndrome Name Category (e.g., urgent) Pet Details (e.g., sex, intact,size, age rule, previous diagnoses) Breed Complaints (e.g., 1st and 2ndDegree Chief Complaints, 2nd Degree Complaint) Symptoms (and mode)

Complaint Name Common Names Minimum Category Sex Poison ConsultationAllowed Symptom, weight

Symptom Name Display Name Field Type (e.g., Boolean) High to Low DisplayHigh to Low Vital Scale Points (e.g., No (Value, 0), (Value, 1). ExtremeDiscomfort (Value, 10))

The computing systems (e.g., network nodes or collections of networknodes) on which the PET system may be implemented may include a centralprocessing unit, input devices, output devices (e.g., display devicesand speakers), storage devices (e.g., memory and disk drives), networkinterfaces, graphics processing units, cellular radio link interfaces,global positioning system devices, and so on. The input devices mayinclude keyboards, pointing devices, touch screens, gesture recognitiondevices (e.g., for air gestures), head and eye tracking devices,microphones for voice recognition, and so on. The computing systems mayinclude high-performance computing systems, cloud-based servers, desktopcomputers, laptops, tablets, e-readers, personal digital assistants,smartphones, gaming devices, servers, and so on. For example, theclassification of the PET system may be performed using ahigh-performance computing system, while the gathering of symptominformation may be performed using a tablet. The computing systems mayaccess computer-readable media that include computer-readable storagemedia and data transmission media. The computer-readable storage mediaare tangible storage means that do not include a transitory, propagatingsignal. Examples of computer-readable storage media include memory suchas primary memory, cache memory, and secondary memory (e.g., DVD) andother storage. The computer-readable storage media may have recorded onthem or may be encoded with computer-executable instructions or logicthat implements the PET system. The data transmission media are used fortransmitting data via transitory, propagating signals or carrier waves(e.g., electromagnetism) via a wired or wireless connection. Thecomputing systems may include a secure cryptoprocessor as part of acentral processing unit for generating and securely storing keys and forencrypting and decrypting data using the keys.

The PET system may be described in the general context ofcomputer-executable instructions, such as program modules andcomponents, executed by one or more computers, processors, or otherdevices. Generally, program modules or components include routines,programs, objects, data structures, and so on that perform tasks orimplement data types of the PET system. Typically, the functionality ofthe program modules may be combined or distributed as desired in variousexamples. Aspects of the PET system may be implemented in hardwareusing, for example, an application-specific integrated circuit (“ASIC”)or field programmable gate array (“FPGA”).

FIG. 9 is a flow diagram that illustrates the processing of an analyzecomponent of the PET system in some embodiments. The analyze component900 generates a recommendation based on complaints and symptomsidentified by a pet owner. In block 901, the component invokes anidentify complaint component through which the pet owner specifies acomplaint relating to the pet. In block 902, the component displays asymptoms display page through which the pet owner can identify thesymptoms associated with the complaint that are exhibited by the pet. Inblock 903, the component invokes a generate recommendation component togenerate a triage recommendation. In block 904, the component displaysthe triage recommendation. In block 906, the component receives aconsultation request indicator from the pet owner. In decision block907, if the consultation is requested, then the component continues atblock 908, else the component completes. In block 908, the componentcalculates and displays a maximum response time for the consultation. Indecision block 909, if the pet owner approves the maximum response time,then the component continues at block 910, else the component completes.In block 910, the component directs the conducting of the electronicconsultation and then completes.

FIG. 10 is a flow diagram that illustrates the processing of an identifycomplaints component of the PET system in some embodiments. The identifycomplaints component 1000 identifies complaints that may match searchterms provided by a pet owner. In block 1001, the component receives thesearch terms from the pet owner. In block 1002, the component retrievesany complaints (i.e., 0, 1, or multiple) that match the search terms andare designated as the chief complaint of a syndrome. In decision block1003, if one complaint is identified, then the component completes,indicating the complaint, else the component continues at block 1004. Indecision block 1004, if no complaint is identified, then the componentcontinues at block 1006, else the component continues at block 1005. Inblock 1005, the component broadens the search terms and loops to block1002 to retrieve complaints that match the broadened search terms. Inblock 1006, the component receives from the pet owner a selection of acomplaint and completes, indicating the complaint.

FIG. 11 is a flow diagram that illustrates the processing of a generaterecommendation component of the PET system in some embodiments. Thegenerate recommendation component 1100 generates a triage recommendationbased on a complaint and symptoms identified by a pet owner. In block1101, the component invokes an identify syndrome component to identify asyndrome associated with the complaint and symptoms. In decision block1102, if a syndrome is identified, then the component continues at block1104, else the component continues at block 1103. In block 1103, thecomponent collects additional information from the pet owner. In block1104, the component invokes a generate categorization component toidentify the categorization for the triage recommendation. In block1105, the component displays the triage recommendation and thencompletes.

FIG. 12 is a flow diagram that illustrates the processing of an identifysyndrome component of the PET system in some embodiments. The identifysyndrome component 1200 identifies a syndrome based on complaints andsymptoms. In block 1201, the component sets a filter based on signalmentand diagnosis of the pet. In block 1202, the component searches forsyndromes that match the complaints, symptoms, and filter. In decisionblock 1203, if there is a full match on a chief complaint, then thecomponent completes, indicating the syndrome, else the componentcontinues at block 1204. In decision block 1204, if there is a partialmatch on the chief complaint or on a second complaint, then thecomponent continues at block 1205, else the component completes,indicating that no syndrome was detected. In block 1205, the componentsolicits information from the pet owner to refine the partially matchingchief complaint. In decision block 1206, if a match is found, then thecomponent completes, indicating the syndrome, else the componentcompletes, indicating that no syndrome was identified.

FIG. 13 is a flow diagram that illustrates the processing of a generatecategorization component of the PET system in some embodiments. Thegenerate categorization component 1300 generates a categorization forthe triage recommendation. The component applies various filters thatgenerate a categorization and indicates the highest categorization. Inblock 1301, the component applies the temperature filter to identify acategorization based on the temperature of the pet. In block 1302, thecomponent applies a minimum for complaint filter to identify the minimumcategorization allowed for the complaint. In block 1303, the componentapplies a minimum for scale point filter to identify the minimumcategorization based on the scale points of the symptoms. In block 1304,the component applies a syndrome filter to identify the categorizationassociated with the syndrome. In block 1305, the component applies thestatistical model filter to identify a categorization and thencompletes.

FIG. 14 is a flow diagram that illustrates the processing of a checkconsultation availability component of the PET system in someembodiments. The check consultation availability component 1400determines whether an electronic consultation is available based on thecomplaint and recommendation. The availability of a consultation mayalso be dependent on whether the pet owner signed up for suchconsultations and whether the initial triage of the pet is still withinthe base response time. In decision block 1401, if a consultation isallowed for the complaint, then the component continues at block 1402,else the component completes, indicating that a consultation is notavailable. In decision block 1402, if the recommendation is anemergency, then the component completes, indicating that a consultationis not available. In decision block 1403, if the recommendation is toseek medical advice, then the component continues at block 1404, elsethe component completes, indicating that a consultation is available. Indecision block 1404, if the base response time for the complaint iswithin the hours of operation of the clinic, then the componentcompletes, indicating that a consultation is available, else thecomponent completes, indicating that a consultation is not available.

FIG. 15 is a flow diagram that illustrates the processing of a conductelectronic check component of the PET system in some embodiments. Theconduct electronic check component 1500 allows a pet owner to update thecurrent condition of their pet. The PET system may send a reminder to apet owner when an electronic check is due. The PET system may require apet owner to update the condition of their pet as a precondition forfurther communications with a clinic. In decision block 1501, if acheck-in is due, then the component continues at block 1502, else thecomponent continues at block 1504. In decision block 1502, if the petowner indicates that the pet is improving, then the component continuesat block 1504, else the component continues at block 1503. In block1503, the component displays a display page through which the pet ownercan provide additional information. In block 1504, the component directsthe conducting of the electronic check (e.g., via a chat session) andthen completes.

FIG. 16 is a flow diagram that illustrates the processing of a definecomplaints component of the PET system in some embodiments. The definecomplaints component 1600 allows a provider of the PET system to specifycomplaints and symptoms and assign symptoms to complaints.(Alternatively, some clinics may be allowed to define their owncomplaints and symptoms or to customize the complaints and symptomsdefined by the provider.) In block 1601, the component provides adisplay page through which the provider can specify the possiblecomplaints. In block 1602, the component displays a display page throughwhich the provider can specify possible symptoms of complaints. In block1603, the component selects the next complaint. In decision block 1604,if all the current complaints have already been selected, then thecomponent completes, else the component continues at block 1605. Inblock 1605, the component displays a display page through which theprovider can assign symptoms to the selected complaint. In block 1606,the component displays a display page through which the provider canassign weights to the symptoms assigned to the selected complaint. Inblock 1607, the component displays a display page through which theprovider can assign any special traits to the selected complaint. Thecomponent then loops to block 1603 to select the next complaint.

The following paragraphs describe various embodiments of aspects of thePET system. An implementation of the PET system may employ anycombination of the embodiments. The processing described below may beperformed by a computing system with a processor that executescomputer-executable instructions stored on a computer-readable storagemedium that implements the message interface system.

In some embodiments, a method performed by one or more computing systemsfor providing triage recommendations for animals is provided. The methodaccesses a syndrome mapping of syndromes to complaints. Each syndromehas a triage category. The method accesses a complaint mapping ofcomplaints to symptoms. Each symptom for a complaint has a weight. Themethod receives indications of a current complaint and current symptomsof an animal, each current symptom having a score. The method identifiesthe triage category based on a syndrome to which the current complaintis mapped, the current complaint, and the current symptoms and based onthe weights and scores. The method indicates a recommendation for theanimal based on the identified triage category. In some embodiments,each symptom for a complaint has a weight and the identifying of thetriage category is based on a combination of the scores and the weightsof the current symptoms. In some embodiments, the identifying of thetriage category is based on a current temperature of the animal. In someembodiments, each complaint is associated with a minimum triage categoryand the identifying of the triage category is based on the minimumtriage category for the current complaint. In some embodiments, eachsymptom is associated with a minimum triage category and the identifiedtriage category is based on the minimum triage category for a currentsymptom. In some embodiments, a triage category is selected from a groupconsisting of emergency, urgent, seek medical advice, worrisome, andnon-threatening. In some embodiments, each triage category is associatedwith a time within which care is to be provided. In some embodiments,the method further indicates that an electronic consultation is notavailable based on the current complaint and based on either the triagecategory being emergency or the triage category being seek medicaladvice when a base response time for seeking medical advice cannot bemet; further, when an electronic consultation is available, the methodsets a response time based on hours of operation of a clinic. In someembodiments, the method further indicates the response time, receives anindication that a consultation is approved, and directs the conductingof the consultation. In some embodiments, the conducting of theelectronic consultation proceeds only after review of the indications ofthe current complaint and current symptoms. In some embodiments, themethod further receives a request for an electronic check and, when anelectronic check is due, receives an indication of whether the animal isnot improving. When the animal is not improving, the method receives anindication of a symptom and conducts the electronic check.

In some embodiments, a method performed by one or more computing systemsfor specifying a syndrome relating to analysis of a condition of ananimal is provided. The method receives specifications of complaints andreceives specifications of symptoms. For each complaint, the methodreceives an indication of one or more symptoms associated with thatcomplaint and generates a mapping of that complaint to those symptoms.For each syndrome, the method receives a minimum triage category forthat syndrome, receives a signalment for that syndrome, and receives oneor more complaints for that syndrome. The method generates a mapping ofthat syndrome to the minimum triage category, the signalment, and thecomplaint. In some embodiments, the complaints include a chief complaintand a secondary complaint. In some embodiments, for each complaint, themethod further receives a weight for each symptom associated with thatcomplaint.

In some embodiments, one or more computing systems for providing triagerecommendations for animals are provided. The one or more computingsystems comprise one or more computer-readable storage mediums forstoring a syndrome mapping of syndromes to complaints, where eachsyndrome has a triage category, and a complaint mapping of complaints tosymptoms, where each symptom for a complaint has a weight. Thecomputer-readable storage mediums further store computer-executableinstructions for controlling the one or more computing systems toreceive indications of a current complaint and current symptoms of ananimal, where each current symptom has a score; identify the triagecategory based on a syndrome to which the current complaint is mapped,the current complaint, and the current symptoms and based on the weightsand scores; and indicate a recommendation for the animal based on theidentified triage category. The one or more computing systems furthercomprise one or more processors for executing the computer-executableinstructions stored in the one or more computer-readable storagemediums. In some embodiments, each symptom for a complaint has a weightand the identification of the triage category is based on a combinationof the scores of the weights of the current symptoms. In someembodiments, each complaint is associated with a minimum triage categoryand the identifying of the triage category is based on the minimumtriage category for the current complaint. In some embodiments, eachsymptom is associated with a minimum triage category and the identifiedtriage category is based on the minimum triage category for a currentsymptom. In some embodiments, the instructions further control the oneor more computing systems to indicate that an electronic consultation isnot available based on the current complaint, based on the triagecategory being emergency, and based on the triage category being seekmedical advice when a base response time for seeking medical advicecannot be met; and when an electronic consultation is available, theinstructions further control the one or more computing systems to set aresponse time based on hours of operation of a clinic. In someembodiments, the instructions further control the one or more computingsystems to indicate the response time, receive an indication that aconsultation is approved, and direct the conducting of the consultation.

Although the subject matter has been described in language specific tostructural features and/or acts, it is to be understood that the subjectmatter defined in the appended claims is not necessarily limited to thespecific features or acts described above. Rather, the specific featuresand acts described above are disclosed as example forms of implementingthe claims. Accordingly, the invention is not limited except as by theappended claims.

1. A method performed by one or more computing systems for providingtriage recommendations for animals, the method comprising: accessing asyndrome mapping of syndromes to complaints, each syndrome having atriage category and a range of scores with a maximum score; accessing acomplaint mapping of complaints to symptoms, each symptom for acomplaint having a weight; receiving indications of a current complaintand current symptoms of an animal, each current symptom having a currentscore; generating urgency scores indicating urgency of the currentcomplaint by fitting a Bayesian model using importance sampling based onthe current score, the maximum score, and weight of each currentsymptom; identifying the triage category using a Bayesian classificationframework based on the triage category with a maximum probability asindicated by the urgency; indicating a recommendation for the animalbased on the identified triage category.
 2. The method of claim 1wherein each symptom for a complaint has a weight and the identifying ofthe triage category is based on a combination of the scores of theweights of the current symptoms.
 3. The method of claim 1 wherein theidentifying of the triage category is based on a current temperature ofthe animal.
 4. The method of claim 1 wherein each complaint isassociated with a minimum triage category and the identifying of thetriage category is based on the minimum triage category for the currentcomplaint.
 5. The method of claim 1 wherein each symptom is associatedwith a minimum triage category and the identified triage category isbased on the minimum triage category for a current symptom.
 6. Themethod of claim 1 wherein a triage category is selected from a groupconsisting of emergency, urgent, seek medical advice, worrisome, andnon-threatening.
 7. The method of claim 1 wherein each triage categoryis associated with a time within which care is to be provided.
 8. Themethod of claim 1 further comprising: indicating that an electronicconsultation is not available based on the current complaint, based onthe triage category being emergency, and based on the triage categorybeing seek medical advice when a base response time for seeking medicaladvice cannot be met; and when an electronic consultation is available,setting a response time based on hours of operation of a clinic.
 9. Themethod of claim 8 further comprising: indicating the response time;receiving an indication that an electronic consultation is approved; anddirecting the conducting of the electronic consultation.
 10. The methodof claim 9 wherein the conducting of the electronic consultationproceeds only after review of the indications of the current complaintand current symptoms.
 11. The method of claim 1 further comprising:receiving a request for an electronic check; when an electronic check isdue, receiving an indication of whether the animal is not improving; andwhen the animal is not improving, receiving an indication of a symptom;and conducting the electronic check. 12-14. (canceled)
 15. One or morecomputing systems for providing triage recommendations for animals, theone or more computing systems comprising: one or more computer-readablestorage mediums for storing: a syndrome mapping of syndromes tocomplaints, each syndrome having a triage category and a range of scoreswith a maximum score: a complaint mapping of complaints to symptoms,each symptom for a complaint having a weight; and computer-executableinstructions for controlling the one or more computing systems to:receive indications of a current complaint and current symptoms of ananimal, each current symptom having a current score; generating urgencyscores indicating urgency of the current complaint by fitting a Bayesianmodel using importance sampling based on the current score, the maximumscore, and weight of each current symptom; identify the triage categoryusing a Bayesian classification framework based on the triage categorywith a maximum probability as indicated by the urgency; and indicate arecommendation for the animal based on the identified triage category;and one or more processors for executing the computer-executableinstructions stored in the one or more computer-readable storagemediums.
 16. The one or more computing systems of claim 15 wherein eachsymptom for a complaint has a weight and the identification of thetriage category is based on a combination of the scores and the weightsof the current symptoms.
 17. The one or more computing systems of claim15 wherein each complaint is associated with a minimum triage categoryand the identifying of the triage category is based on the minimumtriage category for the current complaint.
 18. The one or more computingsystems of claim 15 wherein each symptom is associated with a minimumtriage category and the identified triage category is based on theminimum triage category for a current symptom.
 19. The one or morecomputing systems of claim 15 wherein the instructions further controlthe one or more computing systems to: indicate that an electronicconsultation is not available based on the current complaint, based onthe triage category being emergency, and based on the triage categorybeing seek medical advice when a base response time for seeking medicaladvice cannot be met; and when an electronic consultation is available,set a response time based on hours of operation of a clinic.
 20. The oneor more computing systems of claim 19 wherein the instructions furthercontrol the one or more computing systems to: indicate the responsetime; receive an indication that an electronic consultation is approved;and direct the conducting of the electronic consultation.